Evidence map›Paper›PMID 33310801›Full record

Trial reportBMJ open2020

Antihypertensive drug effects according to the pretreatment self-measured home blood pressure: the HOMED-BP study.

Hikari Sano, Azusa Hara, Kei Asayama, Seiko Miyazaki, Masahiro Kikuya, Yutaka Imai, Takayoshi Ohkubo

Open access · goldAbstract readMulticenter StudyRandomized Controlled Trial
In one paragraph

Trial report in BMJ open, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 1 pooled it
0.6field-weighted citation impact, top 28% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 1 synthesis or guideline pooled it, 9 citations in OpenAlex.

  1. Pooled it
  2. Regional disparities in blood pressure control after hypertension treatment initiation in Japan: a real-world data analysis.Hypertension research : official journal of the Japanese Society of Hypertension · 2026
    Article
  3. Review
  4. The impact of clinical inertia on uncontrolled blood pressure in treated hypertension: real-world, longitudinal data from Japan.Hypertension research : official journal of the Japanese Society of Hypertension · 2024
    Article
  5. Review
  6. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 3 institutions in 2 countries.

Hikari SanoSocial Pharmacy and Regulatory Science, Showa Pharmaceutical University, Machida, Japan.
Azusa HaraDivision of Drug Development and Regulatory Science, Faculty of Pharmacy, Keio University, Minato-ku, Japan.
Kei AsayamaResearch Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Cardiovascular Sciences, Leuven, Belgium kei@asayama.org.ORCID 0000-0003-3365-0547
Seiko MiyazakiSocial Pharmacy and Regulatory Science, Showa Pharmaceutical University, Machida, Japan.
Masahiro KikuyaHygiene and Public Health, Teikyo University School of Medicine, Itabashi-ku, Japan.
Yutaka ImaiTohoku Institute for Management of Blood Pressure, Sendai, Japan.
Takayoshi OhkuboHygiene and Public Health, Teikyo University School of Medicine, Itabashi-ku, Japan.
Teikyo University · JPShowa Pharmaceutical University · JPKeio University · JP

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesTo clarify whether or not the antihypertensive drug effect is proportional to the baseline pretreatment self-measured home blood pressure (HBP) in accordance with the law of initial value (Wilder's law).

designA post-hoc analysis of a multicentre clinical trial.

settingOutpatients across Japan with mild-to-moderate essential hypertension.

participantsAmong 3518 randomised participants, 2423 who self-measured HBP during the pretreatment drug-free period (10-28 days after starting fixed-dose antihypertensive monotherapy) with a mean 7.0 years follow-up were eligible.

main outcome measuresWe analysed individual HBP readings during pretreatment and monotherapy.

resultsThe day-to-day HBP during both the pretreatment period and monotherapy period remains almost the same throughout each period; the results were consistent, regardless of the pretreatment HBP. Following monotherapy, the reduction in the HBP increased by 2.2 mm Hg (95% CI: 1.8 to 2.5 mm Hg) per 10 mm Hg pretreatment HBP increase, up to 11.0 mm Hg (95% CI: 9.9 to 12.0 mm Hg) among patients with an HBP ≥165 mm Hg during pretreatment. Among the 1005 patients receiving low-dose monotherapy (defined daily dose: 0.5 units), the reduction peaked at 8.9-9.1 mm Hg in those with pretreatment HBP 155-164 mm Hg and ≥165 mm Hg (p=0.88).

conclusionsAccording to Wilder's law, the HBP reduction due to fixed-dose monotherapy was proportional to the pretreatment HBP without any regression to the mean phenomenon. With low-dose antihypertensive drugs, however, the HBP reduction peaked in patients with a high pretreatment HBP, indicating the need for such patients to receive a sufficient amount of antihypertensive drug medication at the initial treatment.

trial registrationUMIN Clinical Trial Registry (http://www.umin.ac.jp/ctr), Unique identifier: C000000137.

Indexed as

Antihypertensive AgentsHypertensionBlood PressureBlood Pressure Monitoring, AmbulatoryHumansJapanAntihypertensive Agentscardiologyepidemiologyhypertension

Identifiers

PMID33310801
PMCPMC7735093
OpenAlexW3112516221

What Socratic holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.